MEDICARE: SHANNON RIPLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95023028	CA

General Provider Information

NPI Number	:	1831890458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON RIPLEY

Provider Business Mailing Address
First Line	:	6320 TOPANGA CANYON BLVD STE 1623
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-2298
Country	:	US
Telephone Number	:	747-777-4516
Fax Number	:

Provider Business Practice Location Address
First Line	:	6320 TOPANGA CANYON BLVD STE 1623
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-2298
Country	:	US
Telephone Number	:	747-777-4518
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2023
Last Update Date	:	03/10/2023

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Directions to “ SHANNON RIPLEY ” Practice Location

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